THE MERCK CO-PAY ASSISTANCE PROGRAM

Notice to Qualified Health Plans:

After careful consideration and deliberation, including analysis of the October 30, 2013, and February 6, 2014, letters from former Secretary Sebelius to Representative McDermott (D-WA) and Senator Grassley (R-IA), respectively, Merck has decided to make a co-payment assistance program for this product available to enrollees of a health insurance exchange established by a state government or the federal government who are not Medicaid-eligible. The terms and conditions of our patient co-payment assistance program are available through the link below.

The Merck Co-pay Assistance Program offers assistance to eligible patients who need help affording ZINPLAVA.

Once enrolled, eligible, privately insured patients pay the first $100 of their co-pay.

The Merck Co-pay Assistance Program is not valid for patients covered under a Government Program, as that term is defined on the Terms and Conditions. The Merck Co-pay Assistance Program is not valid for uninsured patients.

Patient and health care professional must submit all required information. Please see the enrollment form for details.

INDEPENDENT ASSISTANCE FOUNDATIONS

Your patients may be able to get help from an independent assistance foundation

Independent assistance foundations may be able to help patients who are encountering hardships affording their prescribed medications or who do not qualify for other forms of financial support.

Each foundation determines its own eligibility criteria and application process and is independent from Merck; there is no guarantee a patient will receive any type of assistance from these organizations.